I have a coder that indicates she’s reporting a diagnosis codes based on documentation of physical exam for an E/M service. For example: Patient presents for rashy "itchy-blistery"skin in contact with dog who has fleas. On skin exam, provider notes punctate erythematous papules. The coder then reports a diagnosis based on exam, L53.8 (Other specified erythematous conditions). Isn’t this an assumption and should be reported as a symptom, R21 (Rash and other nonspecific skin eruption) since there’s no definite diagnosis as of yet? She mentioned she went to a forum and they said it was ok to code from an exam finding?! Any thoughts?